The health benefits of writing about intensely positive experiences

Abstract

In a variation on Pennebaker’s writing paradigm, a sample of 90 undergraduates were randomly assigned to write about either an intensely positive experience (IPE) (n=48) or a control topic (n=42) for 20 min each day for three consecutive days. Mood measures were taken before and after writing. Three months later, measures of health center visits for illness were obtained. Writing about IPEs was associated with enhanced positive mood. Writing about IPEs was also associated with significantly fewer health center visits for illness, compared to controls. Results are interpreted as challenging previously considered mechanisms of the positive benefits of writing.

Introduction

A large body of research supports the idea that writing about important and particularly traumatic life experiences causes improvements in a wide variety of indicators of positive well-being. Research has shown that writing about traumatic life events is associated with enhanced immune functioning (Esterling, Antoni, Fletcher, & Margulies, 1994; Pennebaker, Kiecolt-Glaser, & Glaser, 1988; Petrie, Booth, Pennebaker, & Davidson, 1995), reduced health problems (e.g., Greenberg & Stone, 1992; Pennebaker & Beall, 1986), lower skin conductance levels (Pennebaker, Hughes, & O’Heeron, 1987), and symptom reduction for those with asthma and rheumatoid arthritis (Smyth, Stone, Hurewitz, & Kaell, 1999). Meta-analytic work by Smyth (1998) supports the idea that these effects are robust and similar to those found in other psychological interventions.

Most writing studies have involved writing repeatedly about a negative emotional experience (see King, 2002, for a review). Though such a focus is in keeping with the assumptions of more psychoanalytically oriented notions of human functioning, there is no evidence that this aspect of the writing paradigm is an essential element of the so-called “healing power of writing” (Pennebaker, 1990). For instance, Smyth (1998) found that the negative emotion engendered by traumatic writing was not a significant mediator of the health benefits of writing. Furthermore, analyses by Pennebaker and colleagues (Pennebaker, Mayne, & Francis, 1997; Pennebaker & Seagal, 1999) suggest that negative emotional focus is not an essential characteristic of essays that are likely to be associated with health improvements. Pennebaker and Seagal (1999) suggested that the pattern that was most characteristic of beneficial writing included relatively high levels of positive emotion words, a moderate level of negative emotion words, and increasing insight words over the course of writing. Pennebaker and Seagal (1999) have suggested that disclosive writing studies may be best understood as promoting the creation of narrative sources of meaning—that writing in these studies is a way of making sense out of life experience. Thus, the importance of creating a coherent narrative and gaining understanding of experience has come to be viewed as a crucial mechanism, underlying the benefits of writing. If constructing relatively positive, sensible narratives about life experience is the key to the benefits of writing, it may be worthwhile to consider that such narrative construction may be useful for a wide variety of experiences, not only negative ones. The potential role of positive emotion words in the benefits of writing is also supported to some extent in research showing that nuns who included more positive emotion words in their life stories were more likely to survive to old age (Danner, Snowdon, & Friesen, 2001).

Indeed, research has begun to explore a variety of writing topics that might be associated with health benefits that do not focus exclusively on negative experience. King and Miner (2000) found that writing only about the positive aspects of a traumatic experience was associated with the same health benefits as writing about trauma. King (2001a) found that individuals who wrote about their best possible future selves showed physical health benefits as well as enhanced psychological well-being after writing. Based on these results, King, 2001a, King, 2002 suggested that writing about topics that allow an individual to gain insight into his or her priorities, to understand better what his or her emotional reactions mean, may facilitate physical health, regardless of the emotional tone of the essays themselves. The purpose of the present investigation was to examine whether writing about an important topic (but one that is not intensely negative) might lead to physical health benefits. In this case, we chose to examine the potential health benefits of writing about intensely positive emotional experiences (IPEs).

There are at least two ways in which writing about IPEs might be expected to lead to the health benefits of writing. First, it may be that writing about IPEs has the same impact on the individual as writing about intensely negative experiences. For instance, it may be that examining IPEs through writing brings words to one’s experience, allows insight, and brings coherence to previously unexamined life events (e.g., Pennebaker, 1997). Writing about IPEs may provide similar opportunities for self examination. From this perspective, we would expect that the effects of writing on health would be mediated by, for instance, the language used in writing. Pennebaker and colleagues have identified especially increasing insight words as indicative of particularly beneficial writing. To the extent writing about IPEs is associated with the use of more insight words, it is likely to lead to enhanced physical health.

However, contrasting the effects of positive and negative mood on cognitive processes, it may well be that the effects of writing about IPEs differs in central ways from writing about negative experiences. Clore (e.g., Clore & Tamir, 2002) has proposed that negative mood is associated with more analytical processing and sends the message to the person to continue working on a task. From this perspective, it seems logical that writing about negative experiences would be associated with accruing insight and working toward resolution. However, the effect of positive mood on cognitive processing differs considerably. Positive mood is associated with more global, heuristic processing and sends the message that the individual needn’t continue processing. Thus, it may be that writing about positive events is less likely to lead to analytically derived insight. Furthermore, while negative events seem more intuitively to “require” cognitive processing, positive events may be more likely to be viewed as less crucial to “work through.”

If writing about positive events differs centrally from writing about negative events, is there still reason to believe that such writing may afford health benefits? Recently, research and theory has begun to point to the benefits of positive emotion. Fredrickson’s (1998) “broaden and build” model of positive emotion suggests that positive emotional experience, in contrast with negative emotional experience, broadens the individual’s attention and thought processes and presents an opportunity for building skills. In her model, Fredrickson proposes that positive emotional experiences can have enduring benefits for the individual, as they allow him or her to accrue important skills. In support of this notion, Fredrickson and Joiner (2002) have shown that positive emotional experiences do indeed relate to enhanced functioning as well as an increased capacity to benefit from such positive experiences. Research by Isen, 1999, Isen, 2001 provides evidence for the effects of positive mood on creativity and efficient problem solving (e.g., Estrada, Isen, & Young, 1994) and suggests that positive mood can facilitate the integration of information and allow individuals (in this case doctors) to avoid the cognitive biases associated with anchoring effects (Estrada, Isen, & Young, 1997). This literature suggests that to the extent that writing about an emotional experience induces positive mood, it might be expected to enhance individuals’ coping skills and improve the efficiency of decision making. Such a line of reasoning would suggest that experienced positive mood during writing might mediate the effects of writing topic on health. In addition, writing that reflects “broadening” processes such as global thinking, creativity, and the like, might be more likely to lead to health benefits.

Participants in this study were randomly assigned to write about an IPE or about a control topic for 20 min each day over three days. Participants completed measures of mood before and after writing, and rated their essays on a variety of dimensions. In addition, independent judges coded the essays in a variety of ways, in order to test for the potential mediators we have considered so far. Finally, a computerized word count program (Linguistic Inquiry and Word Count, LIWC, Francis & Pennebaker, 1992; Pennebaker & Francis, 1996) was used to provide a measure of language use in these essays.

Our goal was to examine the implications of this kind of positive writing for mood and physical health. We predicted that writing about IPEs would be related to enhanced positive mood after writing and to decreased health center visits for illness over time, relative to a control group.

In addition to our main hypothesis, we tested three main mediational predictions. First, we examined whether positive mood induced by writing mediated the health effects of writing. Such a possibility follows from the notion that positive moods enhance coping capacity. It may be that individuals who wrote in the most intensely positive ways would be most likely to benefit from writing about IPEs. Second, we examined whether word usage would mediate the effects of writing topic on health. Previous research on writing has found that the use of words indicating positive emotional content (relative to negative, Danner et al., 2001; Pennebaker et al., 1997) and the mobilizing of cognitive resources is associated with particularly good health outcomes (e.g., Pennebaker et al., 1997). It may that writing in a “healthy manner” is associated with health benefits regardless of the topic that initiates the writing. Thus, we examined whether the use of more positive relative to negative emotion words, as well as high or increasing levels of cognitive insight words would explain the health benefits of writing. Finally, the potential mediational effects of “broadened” writing were examined. In this case, we sought to examine whether individuals whose writing seemed to show a broadened sensibility (as described in Fredrickson’s, 1998, broaden and build model) would show enhanced physical health. Fredrickson has suggested that positive emotions, unlike negative emotions, broaden our thinking, enhancing creativity, perspective taking, etc. Negative emotions, in contrast, are more likely to narrow cognition (Clore & Tamir, 2002). Because “broadening” might be a unique explanatory mechanism for writing about positive experiences, we included coding of this type of thinking in the present study.